CARLA RUDOLPH (NPI# 1104182328) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104182328 |
| Entity Type | Individual |
| Full Name | CARLA RUDOLPH |
| Credential | DO |
| Practice Address |
1851 Old Us 66 Edgewood NM 87015-7200 |
| Practice Telephone | 5052862396 |
| Mailing Telephone | 5052862396 |
| Enumeration Date | 2012-04-02 |
| Last Update Date | 2020-05-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | A-1770-13 | NM | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 1104182328 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437264025 | Carla Denyce Rudolph | Chiropractor | 1139 Bush Street, Suite D, San Carlos, CA 94070 | 2006-08-21 |
| Street Address |
1851 OLD US 66 |
| City | EDGEWOOD |
| State | NM |
| Zip Code | 87015-7200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376512632 | Harry Schnee Messec | Family Medicine | 1851 Old Us 66, Edgewood, NM 87015-6784 | 2006-03-17 |
| 1902468861 | Elizabeth Moran | Family Medicine | 1851 Old Us 66, Edgewood, NM 87015-6784 | 2019-07-01 |
| 1962811695 | Joshua Jones | Physician Assistant | 1851 Old Us 66, Edgewood, NM 87015-6784 | 2014-08-06 |
| 1932449113 | Bebe Makena | Specialist | 1851 Old Us 66, Edgewood, NM 87015 | 2013-02-25 |
| 1609885243 | Sandia Mountain Medical, Inc. | Nurse Practitioner | 1851 Old Us 66, Unit 1, Edgewood, NM 87015-6784 | 2006-08-05 |
| 1699720714 | Sanford Lee Yankow | Family Medicine | 1851 Old Us 66, Edgewood, NM 87015-6784 | 2006-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740772490 | Laura Hunsucker | Physical Therapist | 1090 Mountain Valley Road, Edgewood, NM 87015 | 2018-05-30 |
| 1295194629 | Ryan Grange | Physician Assistant | 1851 Old Highway 66 Unit 1, Edgewood, NM 87015 | 2016-02-12 |
| 1376895250 | Bianca Genco-morrison | Social Worker | 17 Venus Rd. West, Edgewood, NM 87015 | 2012-10-03 |
| 1447541909 | Rona H Vanwilligen | Physical Therapist | 1851 Highway 333, 2-b, Edgewood, NM 87015 | 2011-05-02 |
| 1679717789 | Alan Mannheimer | Pediatrics | 104 Quail Trail, Unit B, Edgewood, NM 87015 | 2009-04-21 |
| 1003085705 | Wal-mart Stores East, Lp | Eyewear Supplier (Equipment, not the service) | 66 State Road #344, Edgewood, NM 87015 | 2008-02-27 |
| 1821270828 | Fowler Enterprises, Inc. | Physical Therapist | 1851-2b Old Highway 66, Edgewood, NM 87015 | 2007-11-30 |
| 1366630121 | Jeana Spindle | Speech-Language Pathologist | 27 Camino Estribor, Edgewood, NM 87015 | 2007-10-05 |
| 1679794457 | Sharon Louise Meyer | Social Worker | 14 El Prado, Edgewood, NM 87015 | 2007-05-01 |
| 1912035478 | Cecilia Gonzales Morris | Occupational Therapist | 204 Dinkle Road, Edgewood, NM 87015 | 2007-02-28 |
| Find all providers in zip 87015 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841469723 | Rafiq Patel M D P A | General Practice | 1952 Pulaski Highway, Edgewood, MD 21040 | 2008-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023616679 | Gemma Cristina Zapater | General Practice | 923 Calle Fuerte Ne, Albuquerque, NM 87113-2373 | 2020-10-15 |
| 1710596036 | Provider Cares Network LLC | General Practice | 10401 Montgomery Pkwy Ne Ste 1a, Albuquerque, NM 87111-3876 | 2020-07-23 |
| 1154948081 | Designed Health Options, LLC | General Practice | 5065 Corrales Rd., Corrales, NM 87048 | 2020-06-26 |
| 1538714381 | Uyama A Fernandez | General Practice | 400 Gold Ave Sw Ste 220, Albuquerque, NM 87102-3278 | 2019-08-08 |
| 1386180909 | Lisselle Marie Villarrubia Ocasio | General Practice | Msc10 6000 1 University of New Mexico, Albuquerque, NM 87131-5505 | 2017-01-07 |
| 1225586969 | Joan Goldsworthy | General Practice | Unm School of Medicine Msc09 5040, 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2016-09-12 |
| 1033568902 | Karen Griest | General Practice | 68 Pinon Trl, Cedar Crest, NM 87008-9444 | 2016-06-10 |
| 1447610886 | Sean T Mcgee | General Practice | Univeristy of New Mexico, Albuquerque, NM 87131-0001 | 2016-02-27 |
| 1275901266 | Lynn Schrader Sweeney | General Practice | 701 Kerney Dr, Farmington, NM 87401-3660 | 2015-09-08 |
| 1942608708 | Marathon Health, Inc. | General Practice | 2208 W Main St, C/o Concho Employee Health Center, Artesia, NM 88210-3720 | 2014-12-10 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.